Further investigation, with inspection of medial parts of thigh showed irregular cortical line of left femur metaphysis with some hyperechogenic expansile soft tissue mass, which is fairly vascularized. This case demonstrates relatively typical appearances of a bone forming osteosarcoma of the distal femur typical location in a 17yearold typical age. In young adults, most localized osteosarcomas occur around the knee. This chapter will highlight the clinical presentation, diagnosis, and treatment of osteosarcoma. Evidence of malignant osteoid bone andor cartilage formation with destructive lesions and sclerosis is characteristic of the disease. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. After age 20, the risk of getting a chondrosarcoma goes up until about age 75. The first radiograph demonstrates an illdefined, mixed lytic and sclerotic mass.
Leiomyosarcoma of bone is just one of the variants of spindle cell sarcoma of bone characterised by the expression of desmin and other markers indicating a significant element of smooth muscle in the tumour, without osteoid production we have investigated the management and outcome of this rare type of primary malignant bone tumour. Pdfcreator allows you to convert files to pdf, merge and rearrange pdf files, create digital signatures and more. Pathological radiological signs are often evident by the time of diagnosis. Most commonly progressive pain sometimes waking from sleep, swelling, and a palpable mass. Learn how to change how pdfs are viewed in firefox with either the builtin viewer or a third party tool. Osteosarcoma can metastasize spread to other parts of the body.
The distal femur and adjacent tibial plateau has been resected and a total knee replacement inserted. Osteosarcoma is very rare, but it is the most common type of bone cancer in children and teens. Osteosarcoma is a malignant tumor that primarily affects the long bones but can also involve other bones in the body. Osteosarcoma definition of osteosarcoma by medical. In terms of size, the lesion in the distal femur of our patient had progressed much more than the lesions in the fracture fragments figure figure5b. Mri of osteosarcoma of distal femur same patient roll over the images for more information. Localized osteosarcoma affects only the bone in which it developed and the tissues next to the bone, such as muscle and tendon.
It is a benign condition and most of the time does not cause any symptoms and rarely does it require any treatment. The cancer most often grows in the ends of long bones, especially the bottom of the thigh bone femur and the top of the larger shin bone tibia. I was working for a cellular company in 1993, and was in the midst of dropping off new phones to several orthopedic doctors in town, when my life abruptly changed. Us of quadriceps muscle showed unremarkable structure of muscle and quadriceps tendon. Osteosarcoma is a kind of bone cancer that most often affects children, teenagers, and young adults between the ages of 10 and 20. The large or giant dog breeds are those almost exclusively predisposed to the disease and the mean age of affected animals is 8 years. Primary myofibroblastic sarcoma of the bone is a rare spindle cell tumour with, to the best of our knowledge, only eight cases reported in the available english language literature. Distal femoral resection with endoprosthetic reconstruction martin malawer overview the distal femur figure 30. Parosteal osteosarcoma is a lowgrade malignant bone tumor arising from the distal femur and tibia.
Case discussion this case demonstrates relatively typical appearances of a bone forming osteosarcoma of the distal femur typical location in a 17yearold typical age. Chondrosarcomas can develop in any place where there is cartilage. Although several case reports have been published on osteosarcoma of the femur, to the best of our knowledge this report is the first one with such an unusual clinical course. These are examples of the gross pathology specimens of resected conventional osteosarcoma, consisting of both bony and soft tissue areas. It has a bimodal distribution with peaks in the second decade of life and late adulthood. July, 2002 distal femur resection with endoprosthetic reconstruction 227 border and ligaments and menisci are removed. Osteosarcoma in the distal femur two years after an. Nine cases 4 males, 5 females of dedifferentiated chondrosarcoma were treated in our institute. Chondrosarcoma is described as either localized or metastatic. The diseases rarity and its lowgrade features make an accurate diagnosis difficult in most cases. Osteosarcoma is a malignant primary cancer of long bones.
Download free acrobat reader dc software, the only pdf viewer that lets you read, search, print, and interact with virtually any type of pdf file. Wide resection of a parosteal osteosarcoma usually prevents local recurrence. The differential diagnoses of this unusual tumour include various benign entities as well as other sarcomas. Total femur replacement surgery due to a chondrosarcoma a metastatic bone cancer. That is when they will take most of his femur out, send it to pathology and they see how well his tumour has responded to the chemotherapy. Osteosarcoma is commonly found inside the long bones of your body, such as your arm or leg bones. Opening pdfs in word word office support office 365. Pdf large volume osteosarcomas of the femur treated with. The next most common place is in the humerus, the upper arm. The duration of symptoms preceding a definitive diagnosis of osteosarcoma is quite long. In april 2005, after finishing up an 8th month yoga teacher training program, i saw an orthopedic doctor about a lump on my outer left thigh that had started to cause pain above my.
It may also grow on the surface of your bones or in soft tissue, such as muscles. In literature, hemicortical resections of lowgrade malignant bone tumors and allograft reconstruction are described. We present nine patients with osteosarcomas of the femur treated at our institution between 2003 and 2010 with a mean followup of 27 6 to 56 months. The distal femur is a far more frequently affected site compared to the diaphyseal femur.
Total femur replacement surgery due to a chondrosarcoma. Jude childrens research hospital contenido revisado por. A rare case of lowgrade myofibroblastic sarcoma of the. Enchondroma is the name given to a type of a noncancerous growth or tumor which develops in the cartilage within the bones. Converting from pdf to word works best with files that are mostly textfor example, business, legal, or scientific documents.
Mel was 31 when she was diagnosed with osteosarcoma at the distal femur in 1993. Clinical outcome for patients with dedifferentiated. Specifically, it is an aggressive malignant neoplasm that arises from primitive transformed cells of mesenchymal origin and thus a sarcoma and that exhibits osteoblastic differentiation and produces malignant osteoid. Distal femur osteotomy is done at the appropriate location as determined by the preoperative imaging studies fig 1. We describe a new method of resection and reconstruction of parosteal osteosarcoma located in the. Osteosarcoma bone cancer pediatric hematologyoncology. Rotationplasty compromise between amputation and limb salvage mc used for osteosarcoma of the distal femur in skeletally immature patients.
The incidence of pathological fracture in osteosarcoma is from 5% to 12%. An awardwinning, radiologic teaching site for medical students and those starting out in radiology focusing on chest, gi, cardiac and musculoskeletal diseases containing hundreds of lectures, quizzes, handout notes, interactive material, most commons lists and pictorial differential diagnoses. It usually begins in a leg bone either the femur or the tibia near the knee or in the upper arm bone the humerus near the shoulder. In this case, we describe a middleaged female with a primary leiomyosarcoma of the distal femur. Since his tumour doesnt affect his entire femur, they will keep his hip joint and proximal upper femur in tact. Localized chondrosarcoma has not spread out of the bone where the cancer started. The portable document format pdf is a file format developed by adobe in the 1990s to present documents, including text formatting and images, in a manner.
Different ways to access pdf files with firefox firefox help. This is a case of a 15 year old boy who presents with worsening knee pain. Sara was 28 when she was diagnosed with chondrosarcoma at the distal femur. Clinical history 16 year old boy with pain in the right hip and 16 year old boy with pain in the right hip and. Treatment may consist of surgery, chemotherapy, or both.
The tumor location was the long bone in 7 cases femur, n5. Pdf statistics the universe of electronic documents. Patients with osteosarcoma of the distal femur have traditionally been treated with a high aboveknee amputation. Primary leiomyosarcoma of the bone is exceedingly rare. Osteosarcoma is the commonest primary bone sarcoma arising with an incidence of approximately 3 per million populationyear. Enchondroma distal femur what doctors want you to know. We describe the case of a 58yearold caucasian man who. Wittig, md associate professor of orthopedic surgery chief, orthopedic oncology mount sinai medical center. Resection of parosteal osteosarcoma of the distal part of. Distal femur resection with endoprosthetic reconstruction.
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